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RPZ Report/Test 9.29.15
10-05-15;10:52AM; ; # 1©,01 METR c'M;T:ily.r.; ,,, f. • Reduced Pressure Zone Backflow Preventer Valve &Double Check(DC)Assembly Valve Rebuild &Test Report A i o i It pD J4 se .Pioe carte _ 53`Iz lui l k(.4 4's )(c- t /a I 5/95('3 Car 291r'1'h rel roar CA, t,(,ran 1/a0ia Test Yr. Check Valve#1 Check Valve#2 Differential Pressure Relief 1 2 0 4 Leaked( ) Closed (k) Leaked ( ) Closed(k0' Did Not Opal( Overhauled( ) Install( ) Pressure : 12 l Pressure : -5./ Opened At; e2 7 R Cleaned Cleaned Cleaned E Replaced Replaced Replaced P Poppet Poppet Poppet Spring Spring Spring A a Ring 0 Ring 0 Ring Rubber Seat Rubber Seat Rubber Seat I Other Repairs Other Repairs Other Repairs R S Certification #2 Shutoff Valve: 1 hereby certify the foregoing data to be correct and that the device tested is Pass o] functioning within the li 'ts the standards. Fail [I t Signature: at- - Date: c1;a /5' Assembly Final Test Performance: I COLE'ORD RFF066445 I MARY FORD 1F058416I ALAN FARR BE066481 I Metre Testing/Metro mechanical Canwhants,LLC 31222 Cedar Creek lid,H inckiey,MN 55037 6i?..221-,58$8 Pass Plumbing Rand License:PC646918 Mechanical Bond Certificate ID:5054-MB Fail .41•11.111•111111.111111111111111111111114011/ AV yJC 44 6)010 This report is for the purposes of recording only;Owner is responsible for safe operation and upkeep of scheduled maintenance. qSa f97." a to